Relation of Sociodemographic Factors With Primary Cause of Hospitalization Among Patients With Left Ventricular Assist Devices (from the National Inpatient Sample 2012 to 2017)

Cai, Janet; Xia, Wei; Greenberg, Patricia; Okwuosa, Ike S.; Setoguchi, Soko; Akhabue, Ehimare

doi:10.1016/j.amjcard.2022.06.047

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…About 30% of LVAD patients suffer from bleeding from the gastrointestinal tract, likely due to arteriovenous morphological changes in the gastric system, and a non-physiological alteration of the von Willebrand factor [ 2 ]. Infections resulting from the driveline affect approximately 15–47% of patients [ 5 , 6 ]. Other dangerous events, involving about 11% of patients with an LVAD, although with a lower percentage of rehospitalization with the HM3, are linked to neurological ischemias, the causes of which may derive from machinery malfunctions; thrombus formations; and cardiac arrhythmias [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Hyoid Bone Syndrome in a Patient Undergoing Left Ventricular Assist Device Implantation

Bordoni

Escher

2023

Healthcare

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The clinical case describes the presence of hyoid bone syndrome (HBS) in a patient with a left ventricular assist device (LVAD) implantation, and the resolution of painful symptoms through an osteopathic manual technique (unwinding) applied to the tongue. To the knowledge of the authors, it is the first case report involving an LVAD patient with HBS treated with an osteopathic approach. The article briefly reviews the data relating to surgical therapy for patients with a clinical history of end-stage heart failure and symptoms related to HBS and posits some hypotheses on the presence of pain radiating from the hyoid bone to other areas of the body. The text reminds us to place greater clinical emphasis on the palpatory evaluation of the hyoid in the presence of non-specific painful symptoms.

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Section: Introductionmentioning

confidence: 99%

Hyoid Bone Syndrome in a Patient Undergoing Left Ventricular Assist Device Implantation

Bordoni

Escher

2023

Healthcare

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“…Recently developed LVADs with a lower shear stress in the pump seem to be related with fewer LVAD-associated gastrointestinal bleeding events 13,14 . Nevertheless, bleeding events remain a common complication in patients with LVADs, accounting for nearly 20.0% of hospital readmissions 15 . Patients with LVADs exhibit a remarkably severe loss of VWF large multimers compared to patients with severe aortic stenosis based on the VWF large multimer index (VWF-LMI), a quantitative score we proposed 5,16–24 and have widely used 25–27 to evaluate VWF large multimers in VWF multimer analysis.…”

Section: Introductionmentioning

confidence: 99%

von Willebrand factor-related values can predict bleeding events in patients with left ventricular assist devices

Taketomi,

Sakatsume,

Katahira

et al. 2023

Preprint

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BackgroundRecent advances in left ventricular assist device (LVAD) therapy have significantly contributed to the improved management of severe heart failure. The unignorable risk of bleeding events associated with the device therapy, however, remains to be addressed. Predictive factors for bleeding events are not fully defined.MethodsPatients implanted with various types of LVADs were assessed for von Willebrand factor (VWF)-related values and platelet proteins from 2011 to 2023 at Tohoku University Hospital. We evaluated the relationship between these parameters and bleeding events at remote periods after LVAD implantation.ResultsThe VWF large multimer index (VWF-LMI), the ratio of VWF ristocetin cofactor activity to VWF antigen level (VWF:RCo/VWF:Ag), and maximal ristocetin (1.2 µg/mL) induced platelet aggregation (RIPA) rates decreased in a pump speed- and device type-dependent manner. Major bleeding events, defined according to the Interagency Registry for Mechanically Assisted Circulatory Support criteria, occurred in 28.8% (19/66) of the patients. Kaplan–Meier methods, log-rank tests, and Cox regression analyses revealed that VWF-LMI <42.3 (p=0.0002), VWF:RCo/VWF:Ag <0.52 (p=0.0239), and maximal RIPA rate <79.2 (p=0.0012) predicted bleeding events with hazard ratios of 6.96, 2.89, and 13.4, respectively. The platelets of the patients with LVAD support exhibited significantly reduced expression levels of glycoprotein (GPVI; p=0.0334) and glycoprotein b (GPIb; p=0.0061) compared with healthy subjects. Nevertheless, patients with bleeding events did not exhibit reduced GPVI (p=0.5267) or GPIb (p=0.6674) levels compared to those without bleeding events.ConclusionsVWF-related values, including VWF-LMI, VWF:RCo/VWF:Ag, and maximal RIPA rate, but not reduced platelet proteins, predicted bleeding events in patients with LVADs.RegistrationURL:https://www.umin.ac.jp/ctr; Unique identifier: UMIN000027761Clinical PerspectiveWhat Is New?Comprehensive measurements of von Willebrand factor-related values, platelet proteins, and ristocetin-induced platelet aggregation rates were obtained in patients with left ventricular assist device support to evaluate their association with bleeding events.The von Willebrand factor large multimer index, ratio of von Willebrand factor ristocetin cofactor activity to von Willebrand factor antigen levels, and maximal ristocetin-induced platelet aggregation rate predicted bleeding events in patients implanted with a left ventricular assist device.What Are the Clinical Implications?Predictors of bleeding events in patients with left ventricular assist device support were identified in this study. Understanding how von Willebrand factor-related values are associated with bleeding events will facilitate the management of potential bleeding events.The ratio of von Willebrand factor ristocetin cofactor activity to von Willebrand factor antigen levels is a predictor of bleeding events that can be measured and evaluated relatively easily in many centers without special techniques or equipment, in contrast to analysis of the von Willebrand factor large multimer index.

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Is There an Association Between Living in a Rural Area and the Incidence of Postoperative Complications or Hospital Readmissions Following Left Ventricular Assist Device (LVAD) Implantation, Compared to Urban Lvad Recipients? A Systematic Review

Gollapudi,

Banala

et al. 2025

Clinical Cardiology

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BackgroundLeft ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end‐stage heart failure. While LVAD implantation can enhance survival rates and quality of life, the procedure has its risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.MethodsA comprehensive literature review examined studies that compared postoperative outcomes between rural and urban LVAD recipients. Data on adverse events, hospitalizations, and mortality rates were extracted, focusing on the impact of geographic location on these outcomes.ResultsThe review found that rural LVAD recipients may be at a higher risk for certain complications, including gastrointestinal bleeding, ventricular arrhythmias, LVAD complications, and stroke. Rural patients also exhibited higher instances of emergency department visits and hospital readmissions. Despite these challenges, survival rates and heart transplantation outcomes at 1 year were similar between rural and urban recipients. However, rural patients exhibited a higher driveline infection rate at 1 year.ConclusionThe findings of this review suggest that rural residency may be associated with an increased risk of certain postoperative complications and hospital readmissions following LVAD implantation. These results highlight the need for healthcare strategies to address the challenges faced by rural LVAD recipients. Further research is necessary to understand the relationship between geographic location and LVAD outcomes and to develop interventions that can improve postoperative care for this vulnerable population.

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Relation of Sociodemographic Factors With Primary Cause of Hospitalization Among Patients With Left Ventricular Assist Devices (from the National Inpatient Sample 2012 to 2017)

Cited by 4 publications

References 26 publications

Hyoid Bone Syndrome in a Patient Undergoing Left Ventricular Assist Device Implantation

Hyoid Bone Syndrome in a Patient Undergoing Left Ventricular Assist Device Implantation

von Willebrand factor-related values can predict bleeding events in patients with left ventricular assist devices

Is There an Association Between Living in a Rural Area and the Incidence of Postoperative Complications or Hospital Readmissions Following Left Ventricular Assist Device (LVAD) Implantation, Compared to Urban Lvad Recipients? A Systematic Review

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